Could use help understanding the data from my IntelliPAP

[Berthold]

Hello there. I just got the SmartLink module and software for my DeVilbiss IntelliPAP machine and have about two weeks worth of data and could use help in understanding it.

My first question is, how can I learn how to interpret the data? For the life of me I can't get the DeVilbiss website video on how to understand the data from this machine to work (they haven't answered my ticket on how to get it to work), my sleep doc would only help me with it for $115, which does not seem worth it. Do I just keep reading posts on here? Is there another source for me to learn from?

My second question is, do any of you have any thoughts and suggestions on the reports I have posted at this link? (http://bertholdolson.winkflash.com It is in the IntelliPAP data reports folder.) If you know of a better place to post these things, please let me know. There is a summary there for 2 weeks and for all the individual days (except one, the module doesn't seat all that tight and the second night it wasn't in all the way). I raised the lower limit from 6 to 10 after the first couple of nights as my AHI seemed kind of high. I haven't been titrated since 1996 (it was 11 then), so I would like to use this data to help figure out what I should set my pressures at and to see if there are any other problems with leaks or anything else. My mask's expected leak rate at the current pressure is 35.

There is a strangeness about this data too, as what I read on the machine in the morning consistently is 20-40% higher than what these reports say. I asked DeVilbiss about this a week ago, but have not heard back so far. So the numbers on the reports may be off by that much.

Any thoughts? Thanks very much.
Berthold

[jdm2857]

I'll wait for someone more experienced to look at your reports.

But you can paste direct links to the reports into your post, and they will appear here.

[Berthold]

Thanks jdm. It does appear as a live link in my browser, and I'm not sure what else to do to get it to work with other computers, but here is another try.
http://bertholdolson.winkflash.com/

[yardbird]

Berthold-

What, exactly, are you having trouble reading? Are you trying to INTERPRET for the purpose of adjusting therapy? Or are you having difficulty knowing what each item on the reports means?

One of the things I'm noticing, and I haven't looked at ALL of your reports, just about 8 or so, is that you seem to be having lots of hypopnea events but apneas are few to none. Clusters of hypopneas correlate as expected to pressure rises on the machine. Your AHI is made up almost exclusively of hypopneas. I have similar readings from my Intellipap. I bought a recording pulse oximeter to see if I was desaturating during those clustered hypopneas and I apparently NOT desaturating. They also aren't having any apparent adverse effect on heart rate. So while I will still work on getting hypopnea count lower, I'm not going to be frantic about it.

Your leaks are all over the place. I would get those under control before making other changes.

Does that help?

[Berthold]

Thanks for responding Yardbird and asking for clarification. I am at square one both with knowing what all the items mean and how to interpret them so as to know what, if anything, to change.

I borrowed an oximeter a few months ago and my saturation didn't get below 90%, so I am guessing that isn't a problem for me either. If I understand what you wrote about the clusters of hypopneas and the pressure rising with them, this isn't a major problem as the machine is taking care of them. Is that right?

Can you tell me anymore about the leaks? In what way should the leaks be different? Are there too many, too severe? Where would I start in trying to lessen them?

Thanks again for offering help.

[Pugsy]

Your leak line should be much flatter. See my report below. While we can allow for a few fluctuations not to impact data all that much, when you have leaks like yours, the data can be affected significantly. If the machine is always trying to compensate for leaks it doesn't have time to deal with any events properly or even recognize them.

How to fix the leak? Depends on the cause. Straps too tight? Not tight enough? Poor fit? Change in position of sleeping causing mask to shift? I didn't look at all your reports but the ones I saw all had the huge leak.
Try putting the mask on and turn on machine during day and see if you feel air coming out anywhere except the normal vents. Lie down, turn over, etc. Gotta figure out where and fix it, then you can put more stock in the data you see.

[Pugsy]

You are using nasal pillows?? Similar to mine I think.
If so you may be leaking air out of your mouth.... Mouth breathing or at least opening often. This is common with the nasal pillow mask system.
Also, they may not be seated properly and/or becoming dislodged easily.
If mouth breathing we have to keep the mouth shut some how. Chin straps for minor mouth opening issues but for significant issues some people resort to taping or polident strip gluing shut the mouth.

Full face masks are also an option if the problem is opening the mouth.

[Berthold]

Thanks a lot for your thoughts Pugsy. I can see from what you posted that my leak line is nowhere near straight and that I need to work on changing that. I got a chinstrap a few months ago, but it doesn't seem to be doing the job. The Swift II nasal pillow mask that I got last fall seems to leak not at all compared to the rotatable pillows I used for many years, but I will try the daytime tests you suggested to see if I can detect any leaks that way. I suspect I breath through my mouth at night. I haven't used a full face mask since 1997 but would be willing to do so if that were the best way to cut down on leaks. I was looking at a post on this forum last night where a lot of experienced people were singing the praises of the Pur-Sleep chin strap and I could try that too. Learning that my leaks are excessive and need to be dealt with is exactly the thing I was hoping I could find out from getting the module and software, so many thanks to you and Yardbird.
Berthold

[Ganesha]

Berthold,

I always remember some great advise from RestedGal:
She said to fix the leaks first. It ensures you are getting the therapy you need and the numbers you can trust.

I also use the Swift LT Nasal pillows. If the straps are too tight the my leak rate goes up.
A little Lansinoh Lanolin works like gasket seal to cut down on leaks also.

Mark

[timbalionguy]

Very interesting.

I have been using an IntelliPAP for just under 2 months now, and find for the most part it is a good machine. However, I, too seem to exhibit an excessive number of hypopneas. My apneia rate is very low at a start pressure of 10. My hypopna rate varies all over the place, from about 4 to about 11. I seem to find I sleep better on the nights with the high hypopnea rates. This may have something to do with more REM sleep.

I see your pressure graph is pretty flat most of the time, but your mask leak rate is all over the place. The fact that your average and peak leak rate track closely suggests there is something fundamentally wrong with your mask fit. I find my average leak rate is normally pretty good, but the peak leak rate varies a lot. I think this may have to do with little leaks that occur when i change position. This was a bigger problem with the last mask I used, a Quattro FFM.

The IntelliPAP machine is apparently pretty good with coping with leaks until they are up to 95 l/min or thereabouts. Thay is why I think the machine does not score a frank leak until the leak reaches this 95 l/min level.

Last, but not least: the fitting of the Smartlink module. Many people report that the module does not fit tightly. It actually fits very tightly if installed correctly. There are three 'claws' on the back of the module to engage in the machine body. The topmost claws seem to enagage OK, the bottom one may take some 'finessing' to get it to engage. Pressing the lower portion of the module against the machine while releasing the button will help ensure this third claw enagages. If it does enagage, you will have a very solid feeling module that will not separate from the machine body when pulled on. If it does not engage, the lower part will easily pull away from the machine.

A quick question for anyone reading this thread that has an IntelliPAP with a DC power cord option: What size is the fuse in the DC power cord? (I don't want to hijack the thread, just thought other IntelliPAP owners might be reading who might know.)

[DarkSideOfTheMoon]

Hi. I was reading your post because I have the IntelliPAP but haven't received the software yet. I also read your sleep study results. Your study said that you didn't qualify as needing a CPAP. How did you get one and why? Just curious. Thanks!

Cathy

[Berthold]

Hi Cathy,
The short answer (if you look back at the only other post I have started, you can get a longer answer) is that I was diagnosed with OSA in 1996, and have used a CPAP machine ever since. Last fall I had my first sleep study since then, and though the official results of the 4 hours I did sleep were that I don't have OSA, I have plenty of other evidence that I do have it and continue to use my shiny new IntelliPAP. My GP wrote the Rx for it and supports my continued use of it. I have a very high deductible on my insurance and didn't bother trying to involve them in this recent purchase, which I did online, so that avoided that potential fight with my insurer over what I have or don't have. So there you have it.

On a different note, here is a link to my last night's data here for anyone to look at. http://bertholdolson.winkflash.com/ I tightened my chin strap and connected the short hose of my mask to the top of the headgear so the pillow mask wouldn't be getting yanked on when I move around in bed. The leak line looks considerably flatter than my earlier ones. I did get the mask from my DME so I'm going to set up a visit to make sure it fits right.

Thanks for the tip on the SmartLink module fitting timba, I will get it seated better. Thanks for all the thoughts!

[jdm2857]

I was attempting to explain (not very well) that you could embed the direct link (on the WinkFlash page) into your post and get the report to display here. like this:



Just click the Img button above the post text box, and put the link between the Img tags.

[Berthold]

Thanks--how to get the report into a post was not at all obvious to me.

[DarkSideOfTheMoon]

I totally understand!! I had 4 Sleep Studies that said "Nothing wrong" when I kept telling them that I wasn't really asleep like I am at home. No one listened. My last one 2 months ago showed SEVERE OSA.
I also have wanted to scream from the rooftops not to trust the diagnosis of your bed partners!!! My husband insisted that I was just snoring and didn't stop breathing. My RDI was 95.2. I trusted his opinion for awhile but knew something was very wrong with me.
Best of luck to you....
Cathy